Ok.. she started taking Lithium on January 30 - so it's been about 4 weeks

> > How long has she been affected by cognitive impairments?

(based on consultation with my daughter)... since the beginning of the school year.. so probably about the same time the mixed state escalated enough to become noticeable. My high tolerance for pain resulted in it escalating to a crisis state which forced me to recognize that something was terribly wrong. That was in early January, which is when she started the Latuda.